<!DOCTYPE html>
<html lang="zh" xmlns:th="http://www.thymeleaf.org" >
<head>
    <th:block th:include="include :: header('修改挂号信息')" />
    <th:block th:include="include :: datetimepicker-css" />
</head>
<body class="white-bg">
    <div class="wrapper wrapper-content animated fadeInRight ibox-content">
        <form class="form-horizontal m" id="form-register-edit" th:object="${tableRegister}">
            <input name="id" th:field="*{id}" type="hidden">
<!--            <div class="form-group">    -->
<!--                <label class="col-sm-3 control-label">索引：</label>-->
<!--                <div class="col-sm-8">-->
<!--                    <input name="suoying" th:field="*{suoying}" class="form-control" type="text">-->
<!--                </div>-->
<!--            </div>-->
<!--            <div class="form-group">    -->
<!--                <label class="col-sm-3 control-label">预约单号：</label>-->
<!--                <div class="col-sm-8">-->
<!--                    <input name="yuyueNum" th:field="*{yuyueNum}" class="form-control" type="text">-->
<!--                </div>-->
<!--            </div>-->
<!--            <div class="form-group">    -->
<!--                <label class="col-sm-3 control-label">医生工号：</label>-->
<!--                <div class="col-sm-8">-->
<!--                    <input name="doctorNum" th:field="*{doctorNum}" class="form-control" type="text">-->
<!--                </div>-->
<!--            </div>-->
            <div class="form-group">    
                <label class="col-sm-3 control-label">医生姓名：</label>
                <div class="col-sm-8">
                    <input name="doctorName" th:field="*{doctorName}" class="form-control" type="text" readonly>
                </div>
            </div>
<!--            <div class="form-group">    -->
<!--                <label class="col-sm-3 control-label">医生职称：</label>-->
<!--                <div class="col-sm-8">-->
<!--                    <select name="doctorZhicheg" class="form-control m-b" th:with="type=${@dict.getType('sys_yszc')}">-->
<!--                        <option th:each="dict : ${type}" th:text="${dict.dictLabel}" th:value="${dict.dictValue}" th:field="*{doctorZhicheg}"></option>-->
<!--                    </select>-->
<!--                </div>-->
<!--            </div>-->
<!--            <div class="form-group">    -->
<!--                <label class="col-sm-3 control-label">科室名称：</label>-->
<!--                <div class="col-sm-8">-->
<!--                    <select name="keshiName" class="form-control m-b" th:with="type=${@dict.getType('sys_keshi')}">-->
<!--                        <option th:each="dict : ${type}" th:text="${dict.dictLabel}" th:value="${dict.dictValue}" th:field="*{keshiName}"></option>-->
<!--                    </select>-->
<!--                </div>-->
<!--            </div>-->
            <div class="form-group">
                <label class="col-sm-3 control-label">挂号时间：</label>
                <div class="col-sm-8">
                    <div class="input-group date" readonly="true">
                        <input name="guahaoTime" th:value="${#dates.format(tableRegister.guahaoTime, 'yyyy-MM-dd')}" class="form-control" placeholder="yyyy-MM-dd" type="text" readonly>
<!--                        <span class="input-group-addon"><i class="fa fa-calendar"></i></span>-->
                    </div>
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">就诊状态：</label>
                <div class="col-sm-8">
                    <select name="jiuzhengnStatus" class="form-control m-b" th:with="type=${@dict.getType('sys_jzzt')}">
                        <option th:each="dict : ${type}" th:text="${dict.dictLabel}" th:value="${dict.dictValue}" th:field="*{jiuzhengnStatus}"></option>
                    </select>
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">用户名：</label>
                <div class="col-sm-8">
                    <input name="userName" th:field="*{userName}" class="form-control" type="text" readonly>
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">姓名：</label>
                <div class="col-sm-8">
                    <input name="name" th:field="*{name}" class="form-control" type="text" readonly>
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">手机：</label>
                <div class="col-sm-8">
                    <input name="phone" th:field="*{phone}" class="form-control" type="text" readonly>
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">身份证：</label>
                <div class="col-sm-8">
                    <input name="cardNum" th:field="*{cardNum}" class="form-control" type="text" readonly>
                </div>
            </div>
            <div class="form-group">
                <label class="col-sm-3 control-label">挂号金额：</label>
                <div class="col-sm-8">
                    <input name="guahaoDoller" class="form-control" type="text">
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">是否支付：</label>
                <div class="col-sm-8">
                    <select name="payFlag" class="form-control m-b" th:with="type=${@dict.getType('sys_zhifu_flag')}">
                        <option th:each="dict : ${type}" th:text="${dict.dictLabel}" th:value="${dict.dictValue}" th:field="*{payFlag}"></option>
                    </select>
                </div>
            </div>
            <div class="form-group">    
                <label class="col-sm-3 control-label">审核回复：</label>
                <div class="col-sm-8">
                    <input name="shengheHuifu" th:field="*{shengheHuifu}" class="form-control" type="text">
                </div>
            </div>
<!--            <div class="form-group">    -->
<!--                <label class="col-sm-3 control-label">审核状态：</label>-->
<!--                <div class="col-sm-8">-->
<!--                    <select name="shengheStatus" class="form-control m-b" th:with="type=${@dict.getType('sys_shzt')}">-->
<!--                        <option th:each="dict : ${type}" th:text="${dict.dictLabel}" th:value="${dict.dictValue}" th:field="*{shengheStatus}"></option>-->
<!--                    </select>-->
<!--                </div>-->
<!--            </div>-->
        </form>
    </div>
    <th:block th:include="include :: footer" />
    <th:block th:include="include :: datetimepicker-js" />
    <script th:inline="javascript">
        var prefix = ctx + "system/register";
        $("#form-register-edit").validate({
            focusCleanup: true
        });

        function submitHandler() {
            if ($.validate.form()) {
                $.operate.save(prefix + "/edit", $('#form-register-edit').serialize());
            }
        }

        $("input[name='guahaoTime']").datetimepicker({
            format: "yyyy-mm-dd",
            minView: "month",
            autoclose: true
        });
    </script>
</body>
</html>